Unlearning addiction

Congress, in rare bipartisanship, passes a law that will help support the many local efforts to end a heroin ‘epidemic’ and a prescription opioid crisis. Still left undone: a consensus on whether addiction is a ‘disease.’

Bythe Monitor's Editorial BoardJuly 14, 2016

Janice McGrory, who lost her daughter, Liz, to a heroin overdose in 2011, is hugged by her other daughter, Amy, after she spoke during a March 14 signing ceremony of sweeping legislation aimed at reversing a opioid addiction crisis in Massachusetts. Applauding at far left is Boston Mayor Marty Walsh.

In a rare case of bipartisan consensus, Congress has approved a sweeping measure to address the national crisis in heroin use and prescription opioids. The new law, when fully funded, will allow Washington to support what many states and cities are already doing to prevent and treat such addiction.

For all the divisions in the United States, a great deal of unity now surrounds efforts to free people from drug dependency.

In June, the United Nations announced that the US has a “huge” heroin epidemic. Heroin-related deaths have increased five-fold since 2000. In addition, the 2016 election has pushed political candidates to respond to an acute opioid crisis in many states, such as New Hampshire and Ohio.

For his part, President Obama took several steps in March to provide better access to drug treatment. Medical schools are also training students in how not to overprescribe powerful painkillers. Many police departments are adopting the practice of not punishing drug addicts if they come forward for help.

Most states now have two types of laws to deal with the crisis. One is a so-called Good Samaritan law, which grants immunity to a drug user who calls an emergency number when a friend is overdosing. The other tracks prescriptions to make sure addicts are not “doctor shopping” for new opioid scripts.

While more funding is needed for treatment and prevention, one big question that still dogs these efforts is whether drug addiction should be tagged as a chronic disease, treatable by a combination of medical means and rehabilitation. The US National Institute of Drug Abuse advocates for the disease model. Other experts say such an approach only creates a sense of helplessness in these “patients.” They contend drug habits are learned and can be unlearned by intense self-examination and a supportive, loving social environment.

One advocate of the nonmedical approach is neuroscientist Marc Lewis, who was once a longtime drug addict. As he wrote in a 2011 memoir, an addict has fallen into the trap of believing a drug can meet a cluster of needs, such as safety, freedom, and the warmth of close ties. He tells addicts they must “learn to say no in a way that can catch hold, and support it” with a different view of themselves. They must fill their life with meanings richer than the effects of a drug.

While government-backed programs can rescue people in an acute drug crisis, and steer them toward treatment, much of the long-term healing takes place through the quality of an individual’s thinking and relationships. At the very least, the many efforts to curb opioid use have sent a signal of hope to addicts that there is a path to freedom from drugs.